oral and maxillofacial surgery ii. anaesthesia suture · 2017-09-26 · oral and maxillofacial...
TRANSCRIPT
![Page 1: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/1.jpg)
ORAL AND MAXILLOFACIAL SURGERY II.
ANAESTHESIA
SUTURE
![Page 2: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/2.jpg)
PAIN CONTROL - INDICATIONS OF ANAESTHESIA
• Surgical treatment
• Preparation of cavities
• Preparation for crowns
• Endodontic treatment
![Page 3: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/3.jpg)
CLASSIFICATION
• General anaesthesia
• Analgesia (inhalation, sedation)
• Hypnosis
• Local anaesthesia
![Page 4: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/4.jpg)
DRUGS
• Articain 4% with epinephrine 1: 200 000
• Articain 4% with epinephrin 1:100 000
• Mepivacain 3%plain
• Prilocaine 4% with epinephrine 1:200 000
• Prilocaine plain
• Lidocain spray 10%
• Xylocain spray 10%
![Page 5: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/5.jpg)
BENEFITS OF LOCAL ANAESTHESIA
• Comfort for the patient
• Haemostasis (addtion of epinephrin – hormone
of suprarenal gland – arteficial)
• Operator efficiency
![Page 6: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/6.jpg)
LOCAL ANAESTHESIA
• Topical (spray,liquid) applied on mucosa
• By injection
- Infiltration
- Nerve block
- PDL –periodontal ligament anaesthesia
- Intrapulpal anaesthesia
![Page 7: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/7.jpg)
LOCAL ANAESTHESIA CONTRAINDICATIONS
• Allergy
• Serious systemic diseases (blood
circulation)
• Antithrombotic therapy , coagulopathy –
nerve blocked anaesthesia
![Page 8: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/8.jpg)
TOPICAL ANAESTHESIA (ON MUCOSA OR SKIN)
• Liquid
• Spray
• Creme, paste
Only nerve endings are affected
For extraction of primary teth (when roots are completely resorbed)
Anesethesia of the puncture will be
![Page 9: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/9.jpg)
INFILTRATION
• The drug is delivered by infiltration of soft
tissues using syringe and needle.
![Page 10: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/10.jpg)
INFILTRATION ANAESTHESIA
• Suitable for - indications
- simple extractions in maxilla,
- extractions of mandibular incisors, canines
- soft tissue surgery
![Page 11: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/11.jpg)
INFILTRATION
• Syringe with short needle
• Raise lip or cheek The puncture is situated into
mucosa appr. 1cm from fornix vestibuli. Do not
touch periosteum.
![Page 12: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/12.jpg)
NERVE BLOCK ANAESTHESIA
Syringe with long needle
Foramen mandibulare
Foramen mentale
Foramen palatinum
majus
Foramen incisivum
Foramen infraorbitale
![Page 13: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/13.jpg)
NERVE BLOCK ANAESTHESIA
N. alveolaris inferior
Foramen mandibulare
N. Alveolaris inferior
N. lingualis
![Page 14: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/14.jpg)
NERVE BLOCK ANAESTHESIA
Nervus alveolaris inferior
In sulcus colli mandibulae
![Page 15: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/15.jpg)
NERVE BLOCK ANAESTHESIA
N. alveolaris inferior
Indirect
Direct
![Page 16: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/16.jpg)
NERVE BLOCK ANAESTHESIA
N. alveolaris inferior
Indirect Put the forefinger
on the occlusal surface
Rotate inside (nail inside)
1 cm up occlusal surface
the puncture is situated
![Page 17: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/17.jpg)
NERVE BLOCK ANAESTHESIA
N. alveolaris inferior
Indirect
The syringe
on the opposite canine
The needle goes behind
the crista temporalis,
![Page 18: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/18.jpg)
NERVE BLOCK ANAESTHESIA
N. alveolaris inferior
Indirect
The needle goes deeper
in the contact with the bone
The syringe goes mesial
![Page 19: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/19.jpg)
NERVE BLOCK ANAESTHESIA
N. alveolaris inferior
Indirect
3. The contact with bone
is lost, the syringe goes back
Aspiration and a injection of
the drug.
![Page 20: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/20.jpg)
NERVE BLOCK ANAESTHESIA
N. alveolaris inferior
Direct
Put the forefinger
on the occlusal surface
Rotate inside (nail inside)
1,5 cm deep
![Page 21: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/21.jpg)
NERVE BLOCK ANAESTHESIA
N. alveolaris inferior
Direct
The syringe on opposite
Premolars
(laterally of plica ptërygomandibularis, medially of
crista temporalis)
1,5 cm deep
![Page 22: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/22.jpg)
NERVE BLOCK ANAESTHESIA
N. alveolaris inferior
Direct
The puncture at the same place
The syringe on opposite premolars
The puncture goes into the small pink
depression medial from
crista temporalis and lateral from
plica prerygomandibularis
1,5 cm deep
![Page 23: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/23.jpg)
NERVE BLOCK ANAESTHESIA
N. alveolaris inferior
Anaesthetic zone
Molars, premolars, mucosa, skin, bone, tongue
![Page 24: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/24.jpg)
NERVE BLOCK ANAESTHESIA N. mentalis
F. mentale
The puncture is situated behind
the distal surface of 2nd premolar
The needle goes between
roots of premolars from up to down,
Forward and mesially
Anaesthetic zone: Premolars and canine,
mucosa, skin.
![Page 25: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/25.jpg)
NERVE BLOCK ANAESTHESIA
Foramen palatinum majus – nervus palatinum majus
Distal surface of second molar
The puncture is
0,5 – 1 cm before
from behind forward
Anaesthetic zone: Half of palate
![Page 26: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/26.jpg)
NERVE BLOCK ANAESTHESIA
Foramen incisivum – n. nasopalatinus
Nervus incisivus
Papilla incisiva
Next tu papilla,
mesial direction
Triangular area
behind incisors
![Page 27: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/27.jpg)
ANAESTHESIA ON F. INFRAORBITALE
• Find the margo infraorbitalis
• Raise the lip
• The puncture is sitruated between canine and 1st premolar
• The needle goes to the region (appr 1 cm below margo infraorbitalis)
Anaesthetic zone: Canine and premolars
![Page 28: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/28.jpg)
ANAESTHESIA ON TUBER MAXILLAE
• The durg si delivered on tuber maxillae
• The puncture is situated behind 2nd molar
(distal surface), goes behind and upper around
tuber maxillae.
Anaesthetic zone: Upper molars
![Page 29: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/29.jpg)
PDL ANAESTHESIA
• Intraligamentary
• Special syringe (pen or gun) The needle is introduced
into periodontal space – few drops on anaesthetic
• Indication: single extraction, preparation, pulp
exstirpation
![Page 30: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/30.jpg)
![Page 31: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/31.jpg)
Special gun Anaesthetic Needle
![Page 32: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/32.jpg)
The puncture is between gingiva and tooth and goes into gingival sulcus
![Page 33: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/33.jpg)
ANAESTHESIA - COMPLICATIONS
• Bleeding
• Breakage of needle
• Heamatoma
• Allergy (swelling, collaps)
• Patient´s history is necessary!!!!
![Page 34: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/34.jpg)
INTRAPULPAL ANAESTHESIA
• Exstirpation of the pulp – additional
step.
Directly into the pulp chamber
![Page 35: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/35.jpg)
SUTURE
Suture material
Silk,nylon
Needels
- bent, rounded
- straight
Needle holders
- autofix
-without fixation
![Page 36: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/36.jpg)
SUTURE
Suture material
Silk,nylon
Needels
- bent, rounded
- straight
Needle holders
- autofix
-without fixation
![Page 37: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/37.jpg)
SUTURE
Tweezers – tissue forceps
![Page 38: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/38.jpg)
The puncture is situated appr. 2 mm
from the border of the wound
In the same depth - opposite
The knot is out of the wound
![Page 39: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/39.jpg)
Single suture
Coninuing suture
![Page 40: ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE · 2017-09-26 · ORAL AND MAXILLOFACIAL SURGERY II. ANAESTHESIA SUTURE . PAIN CONTROL - INDICATIONS OF ANAESTHESIA •Surgical](https://reader030.vdocument.in/reader030/viewer/2022040107/5ed59e9f1b7fdd786a1b5885/html5/thumbnails/40.jpg)
Mattress suture
Cross mattress suture